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COVID vaccines

Japan enlists lab staff and paramedics to reach 1m jabs a day

Suga also eyes pharmacists in all-out effort to speed up vaccinations

Senior citizens wait to receive the Moderna COVID-19 vaccine at a newly opened large-scale coronavirus vaccination center in Aichi Prefecture.   © Reuters

TOKYO -- Japan will relax medical rules to allow more workers in the field to administer coronavirus vaccines as it strives to reach Prime Minister Yoshihide Suga's goal of giving 1 million shots a day by mid-June.

The government will expand legal interpretation to authorize paramedics and clinical technologists to give inoculations. This is part of a support program compiled Tuesday to speed up vaccinations, which also includes added payouts to municipalities and medical institutions that administer a certain number of shots.

Currently only doctors, nurses and dentists are allowed to administer vaccines. But with limited staff, Japan has lagged behind other developed nations in inoculation efforts, with the daily total hovering at around 400,000.

The Ministry of Health, Labor and Welfare will soon present the more loose interpretation of the rules at a meeting of experts to open up the duties now only allowed to nurses.

There are 64,000 licensed paramedics in Japan, including about 40,000 who work as firefighters. Licensed clinical technicians number 200,000. Suga said he wants to bring in "tens of thousands" of those workers toward vaccination efforts.

Japan is also looking into enlisting pharmacists for the task. Suga invited Nobuo Yamamoto, president of the Japan Pharmaceutical Association, to his official residence on Monday.

"This will truly be a national undertaking," Suga told Yamamoto, expressing hopes for the 300,000-plus licensed pharmacists.

"There are legal barriers" in letting pharmacists inject vaccines, Yamamoto told reporters after visiting Suga. "If that is resolved, I'm prepared to accept the outcome face to face."

Already, doctors and nurses from the Self-Defense Forces have joined the fray, setting up vaccination sites in Tokyo and Osaka.

Prime Minister Yoshihide Suga called Japan's vaccine drive a true "national undertaking." (Photo by Rie Ishii)

The health ministry initially was reluctant to even allow dentists to administer vaccines but later agreed to relax the rules, and dentists have now become an essential source for vaccines in rural areas.

Suga aims to fully vaccinate by the end of June all elderly people 65 and older who want the inoculation. At least 6.61 million people received at least one shot as of Monday, putting the daily average at less than 400,000 people.

If the daily average is lifted to 1 million by mid-June and maintained at that level, around 70 million doses would be conceivably administered by the end of July, which would cover the entire elderly population.

That prospect has given rise to another goal within the government of administering 20 million shots by June 20. Reports from other countries show that the vaccination campaign yields a meaningful impact in controlling infections once 20% of the population is given at least one dose. In Japan, reaching that threshold means vaccinating 20 million residents.

But if the infrastructure for rapid vaccinations is not in place at the municipal level, those plans could collapse.

Japan's law states that the health ministry is responsible for negotiating with local governments concerning vaccinations. Suga plans have the health and internal affairs ministries work together to make sure local needs are met.

Local governments typically go to community medical associations to request doctors who will assist in vaccinations. On Tuesday last week, the Japan Medical Association issued a statement urging member associations across the country to respond to requests by local governments.

"We would like you to cooperate with the local governments for their vaccine programs as much as possible," the notice read.

On the same day, the health and internal affairs ministries issued a joint statement urging local governments to coordinate with their local medical associations.

Local governments have complained that the health ministry only issues one-sided notices without understanding the conditions on the ground. This joint statement was an attempt by the ministries to signal that the government is not deaf to local concerns. 

Suga and Taro Kono, the vaccine czar, met with Internal Affairs Minister Ryota Takeda to the prime minister's office on April 21. The three discussed how to spur faster vaccinations at the local level.

They eventually turned to senior officials in the internal affairs ministry who have experience working at local governments. Takeda put together a task force staffed with these officials who would work as liaisons to solve problems at the local level.

This all-out approach has produced positive results. In Okayama Prefecture in western Japan, all communities expect to finish vaccinating their entire elderly populations by the end of July. That is up from 63% on May 12.

Shizuoka Prefecture, home to Mount Fuji, once thought it would finish inoculating seniors in August. But now 89% of the communities project they will finish the job by the end of July.

The Japanese government will soon decide whether or not to extend the state of emergency for Tokyo and other prefectures, which is due to expire next Monday. Having a realistic time frame for administering 1 million shots a day would make it easier to determine the length of the extension.

Progress in vaccinations will also help the government's argument that the Tokyo Olympics, which opens July 23, can be held safely. 

Suga is sensitive to the criticism that he is putting the Olympics ahead of people's health.

"The health of the citizens is most certainly my first priority," Suga said indignantly after a visitor to his office informed of the criticism.

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